130 CMR, § 503.004

Current through Register 1536, December 6, 2024
Section 503.004 - Assignment of Rights to Medical Support and Third-party Payments
(A) Every legally able applicant or member must assign to the MassHealth agency his or her rights to medical support and third-party payments for medical benefits provided under Mass-Health as well as the rights of applicants or members for whom he or she can legally assign medical support and third-party payments.
(B) The applicant or member must fully cooperate with the MassHealth agency in
(1) establishing paternity;
(2) obtaining any medical support and payments; and
(3) identifying and providing information to assist the MassHealth agency in pursuing third parties, including a noncustodial parent, who may be legally obligated to pay for care and services for the applicant or member, or person on whose behalf benefits are requested, unless the applicant or member has grounds to waive cooperation as described in 130 CMR 503.005 or 505.002(D): Eligibility Requirements for Pregnant Women.
(C)
(1) The MassHealth agency will deny eligibility for any applicant who does not attest to a willingness to cooperate and terminate eligibility for any member who refuses to cooperate, unless the applicant or member demonstrates good cause, as described in 130 CMR 503.005, or is a pregnant woman who meets the requirements of 130 CMR 505.002(D): Eligibility Requirements for Pregnant Women.
(2) The MassHealth agency will not deny or terminate eligibility of any applicant or member who cannot legally assign his or her own rights, including, but not limited to, a minor child, and who would otherwise be eligible but for the refusal, by a person legally able to assign the child's rights, or to cooperate as required in 130 CMR 503.004.

130 CMR, § 503.004

Amended by Mass Register Issue 1355, eff. 12/29/2017.